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The impact of perioperative oral care on postoperative infection in patients with esophageal cancer: a retrospective cohort study before and during COVID-19

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Abstract

Purpose

This study evaluated the impact of preoperative oral hygiene on the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) in patients undergoing esophageal cancer surgery considering the influence of COVID-19 and developing effective perioperative oral care methods.

Methods

The medical records of patients who underwent esophageal cancer surgery between January 2017 and March 2022 were analyzed. Patient characteristics and the incidence of PP and SSI before and during COVID-19 were compared. A multiple logistic regression analysis was performed with PP and SSI as the dependent variables.

Results

This analysis included 207 participants. The mean age was 66.6 ± 8.3 years old, and 78.3% were male. There were no significant changes in the incidence of PP or SSI before and during the COVID-19 pandemic. Preoperative xerostomia significantly increased the risk of PP (odds ratio = 3.34, 95% confidence interval 1.10–10.08, p = 0.033), an advanced cancer stage, and recurrent laryngeal nerve palsy. Surgical procedures and reconstructive organs, but not preoperative oral hygiene factors, were associated with SSI.

Conclusions

The incidence of PP and SSI in patients with esophageal cancer showed no marked changes before or during the COVID-19 pandemic. Managing preoperative xerostomia may be crucial for reducing the risk of PP.

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Acknowledgements

The authors are grateful to the patients with esophageal cancer at the Department of Gastroenterology and General Surgery at Kyushu University Hospital. We would like to thank Editage for the English language editing. This study was supported by the JSPS KAKENHI (Grant Number JP22H03389).

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Authors and Affiliations

  1. Department of Health Sciences, Graduate School of Medicine, Kyushu University, 3-1-1 Maidashi Higashiku Fukuoka City, Fukuoka, 812-8581, Japan

    Aoi Kubo, Kimie Fujita & Satomi Tanaka

  2. Gastrointestinal Surgery, NHO Kyushu Cancer Center, 3-1-1 Notame Minamiku Fukuoka City, Fukuoka, 811-1395, Japan

    Yasue Kimura

  3. Faculty of Dental Science, Department of General Dentistry, Kyushu University, 3-1-1 Maidashi Higashiku Fukuoka City, Fukuoka, 812-8581, Japan

    Naohisa Wada

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  1. Aoi Kubo
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Correspondence to Aoi Kubo.

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Kubo, A., Fujita, K., Tanaka, S. et al. The impact of perioperative oral care on postoperative infection in patients with esophageal cancer: a retrospective cohort study before and during COVID-19. Surg Today (2025). https://doi.org/10.1007/s00595-025-03025-x

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